High levels of homocysteine in human plasma are correlated with increased risks for coronary heart disease, stroke, arteriosclerosis, and other diseases. As a result, it is desirable to screen the general population for elevated amounts of this amino acid. To make wide-scale testing for homocysteine feasible, new and less expensive assays need to be developed.
Plasma homocysteine is routinely measured by high-pressure liquid chroma-tography (HPLC) and gas chromatography/mass spectrometry (GC/MS) at a cost of over $100 per assay, making these physical separation methods too costly for a population-wide study. For example, urine or blood samples can be prepared for amino acid chromatography, and L-homocysteine measured by HPLC separation and detection. Fiskerstrand et al. (Clin. Chem., 39:263-271 (1993)) describe a method of assaying L-homocysteine using fluorescent labeling of serum thiols, followed by HPLC separation and detection of the L-homocysteine derivative from the various other sulfur-containing compounds. However, such methods are typically time consuming, costly, and not readily available to many laboratories.
Indirect immunoassays for homocysteine have also been developed, however, these antibody methods are still relatively expensive at about $24 per test. One particular indirect immunoassay enzymatically converts homocysteine to adenosyl homocysteine and the amount of adenosyl homocysteine is determined by a competitive ELISA (enzyme linked immunoassay), using an anti-adenosyl homocysteine antibody (for example, see U.S. Pat. No. 5,827,645, the content of which is incorporated herein by reference).
Indirect enzyme assays have been developed for the quantitation of L-homocysteine. For example, the enzyme S-adenosyl-homocysteine hydrolase and adenosine are added to a test sample. The resulting concentration, or change in the concentration, of adenosine in the reaction mixture is used as an indicator for the initial concentration of homocysteine in the sample.
Direct enzyme assays have also been reported for measuring homocysteine. Typically, these protocols irreversibly convert homocysteine to other compounds that are quantifiable. For example, the enzyme homocysteine dehydratase has been used to remove the sulfhydryl group from homocysteine. The concentration of the removed sulfhydryl moiety is then measured. A major drawback with this and other enzyme assays for homocysteine is that the enzymes employed react with other sulfur containing amino acids and compounds related to homocysteine, leading to a high and inconsistent background and measurements of homocysteine from plasma that are inaccurate.
Enzymatic (or enzymic) cycling assays have been reported for a very small number of analytes. In an enzymatic cycling assay two or more enzymes activities are used which recycle substrate and do not irreversibly convert the measured compound. Instead the “compound” is used catalytically to control the rate of conversion to the quantitated compound in the assay. As a result, the analyte of interest remains in a steady-state concentration which is low enough to create a pseudo-first order rate of reaction. The steady-state concentration of the analyte is thereby linearly related to the rate of the overall assay. By measuring reaction rates, the amount of the analyte is easily determined. Enzymatic cycling assays are sometime called “amplification” assays, because the methods typically increase the sensitivity of measurement for an analyte by 100- to 1000-fold. The amplification in measurement is a direct result of not reducing the steady-state concentration of the compound. No enzymatic cycling assay has been reported for measuring homocysteine.
The present invention provides an enzymatic cycling assay for homocysteine and/or cystathionine which is less expensive, and provides a higher sample throughput than the diagnostic assays currently available. Further, the invention provides methods and vectors for the recombinant production of enzymes which can be used in the production of assay reagents and test kits for assessing the amount of homocysteine and cystathionine in a sample.